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Vol.47, No.2, 2013
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Archive (2009~
Archive-the Korean Journal of Pathology(1967~2008)
Archive-the Korean Journal of Cytopathology(1990~2008)
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  Vol.46, No.3:233-236, June 2012
Original articles
http://dx.doi.org/10.4132/KoreanJPathol.2012.46.3.233
Urinary Decoy Cell Grading and Its Clinical Implications

Myoung Ju Koh¤ýBeom Jin Lim¤ýSongmi Noh¤ýYon Hee Kim¤ýHyeon Joo Jeong

Department of Pathology, Yonsei University College of Medicine, Seoul, Korea

Background : Examination of urine for decoy cells (DCs) is a useful screening test for polyomavirus (PV) activation. We explored the significance of the amount of DCs in persistent shedding, PV nephropathy and acute rejection.

Methods : A case-controlled study was performed in 88 renal allograft patients who had DCs detected at least once in four or more urine samples.

Results : Fifty one patients were classified into the high-grade shedding group (HG) and 37 patients into the low-grade shedding group (LG) according to DC shedding (¡Ã10 or <10 DCs/10 high power field [HPF]). DC shedding of more than three consecutive months was significantly more prevalent in the HG as compared with their LG counterparts (p<0.0001). Urinary DCs were present for more than one year in 29.4% of the HG and 8.1% of the LG. Real-time polymerase chain reaction for PV was higher in both urine (51.4% vs. 11.1%) and plasma (9.1% vs. 0%) of the HG than the LG. The prevalence of PV nephropathy was higher in the HG than the LG (p=0.019). However, there was no significant difference in the prevalence of acute rejection.

Conclusions : Shedding of ¡Ã10 DCs/10 HPF is associated with sustained shedding, polymerase chain reaction positivity and PV nephropathy, but not a predictor of acute rejection.
Key Words : Decoy cell; Polyomavirus nephropathy; Monitoring

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